Transition of Fee. For-Service (FFS) Members Providing care coordination for prescheduled health services, access to preventive and specialized care, care management, member services, and education with minimal disruption to members’ established relationships with providers and existing care treatment plans, is critical for members transitioning from FFS to managed care. The MCP is not required to continue services identified in 33.b and 33.c of this Appendix for a member who resides in a service area in which enrollment in an MCP is not required and the member voluntarily chooses to enroll in the MCP.
Transition of Fee. For-Service Members Providing care coordination for prescheduled health services and existing care treatment plans, is critical for members transitioning from Medicaid fee-for service (FFS) to managed care. Therefore, MCPs must:
Transition of Fee. For-Service Members Providing care coordination, access to preventive and specialized care, case management, member services, and education with minimal disruption to members’ established relationships with providers and existing care treatment plans is critical for members transitioning from Medicaid fee-for-service to managed care. MCPs must develop and implement a transition plan that outlines how the MCP will effectively address the unique care coordination issues of members in their first three months of MCP membership and how the various MCP departments will coordinate and share information regarding these new members. The transition plan must include at a minimum:
